Stress fractures are small cracks in a bone. These fractures are most often a result of “overuse” and are commonly seen when someone has a recent increase in their activity.
Stress fractures occur most commonly in the weight-bearing bones of the legs. When these bones are subjected to a “new stress,” such as a new exercise routine, they may not be well-adapted, and as a result, they may crack under the new stresses being applied.
Symptoms and Clinical Presentation
The symptoms of stress fractures can vary widely. However, most commonly patients, complain of pain. The pain may develop gradually and often is relieved by rest. The pain usually becomes more intense with physical activity and can be associated with swelling. Swelling and tenderness may be present in the area of pain. It is rare to see bruising or discoloration.
Cause (including risk factors)
Overuse is the first cause of stress fracture. This may be confusing, but overuse could simply mean a change in activity as well. An increase in exercise, athletics, job duties, or even shoewear can bring on a stress fracture. Some patients even report stress fractures after a simple change, like going on a vacation where an unusual amount of walking was done.
Other risk factors include certain sports that have a high frequency of repetitive activity. In particular, running and jumping sports may cause stress fractures.
Osteoporosis may also place a patient at risk for stress fracture. Weak or brittle bones may not be able to handle even the simplest of changes in activity, and as a result, development of a stress fracture is more likely.
As with all medical conditions, the analysis of a history of the symptoms and the taking of a medical history are vitally important. This interview, along with a medical exam of the foot, will often predict the diagnosis.
To complete the evaluation, a series of X-rays will likely be performed. If the crack is small, or the symptoms are present only for a short time, X-rays may be normal. Therefore, if needed, additional imaging by CT scan, nuclear bone scan, or MRI could be ordered.
*Source: American Orthopaedic Foot & Ankle Society® http://www.aofas.org